Renal transplantation in a patient with end stage renal disease due to cholesterol embolism

Background, Renal failure due to cholesterol emboli is mostly irreversible, Therefore chronic renal replacement therapy is necessary. However, to the best of our knowledge no published experience exists with renal transplanta tion in patients with end-stage renal disease (ESRD) due to cholesterol emb olization (CE). Methods. Renal transplantation was performed in a 64-year-old man who suffe red from ESRD due to CE after coronary angiography. Because our patient pre sented with a typical profile of cardiovascular risk factors effective long -term control of these risk factors before and after transplantation was a mandatory prerequisite before considering transplantation. Results. After one rejection episode serum creatinine values have been stab le and no major complications have occurred during a follow-up of 18 months . No signs of recurrent cholesterol emboli into the donated kidney were see n in renal biopsies performed due to graft rejection. Conclusion. Cholesterol embolization is an uncommon reason for ESRD and mai nly occurs after invasive vascular procedures in patients with hyperlipidem ia, arterial hypertension, and smoking. Because ESRD due to CE often is irr eversible, chronic renal replacement therapy may be necessary. As demonstra ted in our report, renal transplantation should be considered, However, in this setting effective long-term control of the underlying risk factors bef ore and after renal transplantation has to be ensured.